title: Vitamin and mineral deficiencies are highly prevalent in newly diagnosed celiac disease patients.
abstract: Malabsorption, weight loss and vitamin/mineral-deficiencies characterize classical celiac disease (CD). This study aimed to assess the nutritional and vitamin/mineral status of current "early diagnosed" untreated adult CD-patients in the Netherlands. Newly diagnosed adult CD-patients were included (n = 80, 42.8 ± 15.1 years) and a comparable sample of 24 healthy Dutch subjects was added to compare vitamin concentrations. Nutritional status and serum concentrations of folic acid, vitamin A, B₆, B₁₂, and (25-hydroxy) D, zinc, haemoglobin (Hb) and ferritin were determined (before prescribing gluten free diet). Almost all CD-patients (87%) had at least one value below the lower limit of reference. Specifically, for vitamin A, 7.5% of patients showed deficient levels, for vitamin B₆ 14.5%, folic acid 20%, and vitamin B₁₂ 19%. Likewise, zinc deficiency was observed in 67% of the CD-patients, 46% had decreased iron storage, and 32% had anaemia. Overall, 17% were malnourished (>10% undesired weight loss), 22% of the women were underweight (Body Mass Index (BMI) < 18.5), and 29% of the patients were overweight (BMI > 25). Vitamin deficiencies were barely seen in healthy controls, with the exception of vitamin B₁₂. Vitamin/mineral deficiencies were counter-intuitively not associated with a (higher) grade of histological intestinal damage or (impaired) nutritional status. In conclusion, vitamin/mineral deficiencies are still common in newly "early diagnosed" CD-patients, even though the prevalence of obesity at initial diagnosis is rising. Extensive nutritional assessments seem warranted to guide nutritional advices and follow-up in CD treatment.
authors.affiliation: Department of Nutrition and Dietetics, VU University Medical Centre, P.O. Box 7057, Amsterdam 1007 MB, The Netherlands. N.Wierdsma@vumc.nl.
authors.forename: Nicolette J
authors.initials: NJ
authors.lastname: Wierdsma
authors.forename: Marian A E
authors.initials: MA
authors.lastname: van Bokhorst-de van der Schueren
authors.forename: Marijke
authors.initials: M
authors.lastname: Berkenpas
authors.forename: Chris J J
authors.initials: CJ
authors.lastname: Mulder
authors.forename: Ad A
authors.initials: AA
authors.lastname: van Bodegraven
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015992:Body Mass Index; D016022:Case-Control Studies; D002446:Celiac Disease / Q000097:blood / Q000150:complications / Q000175:diagnosis*; D015331:Cohort Studies; D055050:Diet, Gluten-Free; D005260:Female; D005293:Ferritins / Q000097:blood; D005492:Folic Acid / Q000097:blood; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D008297:Male; D018977:Micronutrients / Q000008:administration & dosage* / Q000172:deficiency*; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D009752:Nutritional Status; D009765:Obesity / Q000097:blood / Q000150:complications / Q000453:epidemiology; D015995:Prevalence; D014801:Vitamin A / Q000097:blood; D014805:Vitamin B 12 / Q000097:blood; D025101:Vitamin B 6 / Q000097:blood; D014807:Vitamin D / Q000097:blood; D015431:Weight Loss; D055815:Young Adult; D015032:Zinc / Q000097:blood
chemical_list: D006454:Hemoglobins; D018977:Micronutrients; D014801:Vitamin A; D014807:Vitamin D; D025101:Vitamin B 6; D005293:Ferritins; D005492:Folic Acid; D015032:Zinc; D014805:Vitamin B 12